C5 Motor Palsy After Single- and Multi-level Anterior Cervical Diskectomy and Fusion: A Retrospective Review

Scott C. Wagner*, Arjun S. Sebastian, Joseph S. Butler, Ian D. Kaye, Patrick B. Morrissey, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


Introduction: Postoperative C5 nerve root palsy is a known complication after cervical surgery. The effect of increasing number of levels fused on the prevalence of C5 palsy after anterior cervical diskectomy and fusion (ACDF) is unclear. Methods: Medical records of ACDF patients that included the C4-5 level at one institution were retrospectively reviewed. C5 palsy was defined as motor decline of the deltoid and/or biceps brachii muscle function by at least 1 level on standard manual muscle testing. Results: A total of 196 patients met the inclusion criteria, with no significant differences noted between groups undergoing single- or multi-level ACDF. The overall C5 palsy rate was 5.1%. Palsy rates were not statistically significant based on the number of levels fused. Six of the 10 patients with C5 palsy had complete recovery of motor strength, whereas 2 patients had at least some level of strength recovery. Conclusion: The overall C5 palsy rate was 5.1% for all patients undergoing up to four-level ACDF. The rate of postoperative motor decline was lowest in the patients undergoing two-level ACDF and highest in the single-level group, but this finding did not reach statistical significance. The prognosis for strength recovery by final follow-up is excellent.

Original languageEnglish
Pages (from-to)E390-E394
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Issue number8
StatePublished - 15 Apr 2019
Externally publishedYes


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